The Prohibition era in America, which lasted for well over a decade and—inconceivable as it might be today—effectively banned the sale and production of booze in the United States, ended with the ratification of the 21st Amendment on Dec. 5, 1933.

In 2003, Mokoena began taking care of grandchildren Ernest, now 21, and Lebusa, now 17, after her eldest daughter died of HIV/AIDS. This May, her second daughter also died of the disease, leaving her to raise five more grandchildren: Teddy, 8, Happy, 13, and Sharon, 15, Mbongeni, 17, and Lineo, 23. The grandchildren don't know how their mothers died. "They are too young to understand," Mokoena says. "This disease eats you from the inside until it is too late. I hope for a better life for my grandchildren. I want them to become accountants and lawyers.”

One night in 2003, Agnes Dlamini woke to the sound of her infant grandson crying. His mother — Dlamini’s daughter-in-law — had died after a long illness. The baby was left on top of her emaciated body, sucking helplessly at his mother’s lifeless breast.

That tragedy, Dlamini now knows, is the result of South Africa’s failure to address the spread of HIV. But back then, she had no idea. At the time, the country’s President Thabo Mbeki was sympathetic to AIDS denialists. His Minister of Health was nicknamed Dr. Beetroot for championing the plant as a treatment for HIV/AIDS. Anti­retroviral drugs weren’t available until 2004 and were difficult to obtain for many years after that.

The legacy of that denial is 3.37 million South African children under 17 without one or both parents, according to a 2011 census. Most are orphans, and some 64% are in the care of grandmothers, who bear the responsibility of a second motherhood.

The age gap makes it challenging for grand­mothers to connect with these kids and warn them about HIV. “I don’t have the right words for it,” says Dlamini, 81. “My granddaughter laughs at me when I try.” High urban unemployment, poverty and crime add to the difficulty of their task. Still, many of the gogos, the Zulu word for grandmothers, say they are hopeful they can break the cycle that claimed their children’s lives.